In our currently fragile economy, lifestyle changes are often necessary to maintain a reasonable budget. We may carpool more often, eat out less frequently, or reduce the number of foreign excursions. While making changes to shave costs are generally helpful, there are some corners that should not be cut.
In a recent study published in the European Journal of Epidemiology, the cost-cutting practice of replacing water for windshield wiper fluid has been linked with an increased risk of developing Legionnaire’s disease.
It appears that stagnant water in wiper fluid reservoirs promote bacterial growth, including the Legionella bacteria that are typically spread through water systems (e.g., air conditioners, showers, and fountains). When sprayed on the windshield, the bacteria are aerosolized and disseminated through air vents or open windows.
The research effort was initiated after a spike in Legionnaire’s disease cases was detected in England and Wales during the summer of 2006. Another observation was the higher prevalence of cases among professional drivers (145 cases of 851,000 drivers of buses, taxis, vans, trucks) compared to other driving citizens (782 cases of 27,061,000 individuals).
The study collected cases of sporadic Legionnaire’s disease between July 2008 and March 2009. Those who had foreign travel preceding the onset of illness, suspected hospital-based transmission, or were part of an outbreak were excluded. A total of 123 cases of sporadic Legionnaire’s disease were identified, of whom 75 were included in the final analyses. There were 67 healthy drivers who served as controls.
Cases and controls were asked to complete a questionnaire about various driving habits: use of a car, use of a van, use of a bus, driving through industrial areas, daily hours with windows open, ever having a window open, driving as part of a job, daily hours in vehicle for the job. They were also asked about various characteristics of their vehicle: year of manufacture, air conditioning, air conditioning temperature, use of concentrate or prediluted windshield wiper fluid. Other exposures considered included use of a train, use of an underground tunnel, showers taken at home, and smoking habits.
By themselves, most variables were statistically associated with an increased risk for Legionnaire’s disease. However, after adjusting for age, sex, season, and smoking, the two exposure variables that contributed to increased odds of developing Legionnaire’s disease were “driving through industrial area” (OR 7.17, 95% CI 1.52-33.73, p=0.007) and not using “screenwash in windscreen wiper fluid” (OR 47.24, 95% CI 3.70-603.63, p<0.001). Without screenwash, the odds of developing Legionnaire’s disease was almost 50 times greater!
The UK Health Protection Agency (HPA) tested the wiper fluid from several cars with and without screenwash. Legionella was detected in 20% (1/5) of the wiper fluid with only water, while 0% (0/16) was detected in the fluid with added screenwash.
The authors estimate that 20% of community-acquired Legionnaire’s disease may be reduced by a simple preventive care strategy that most drivers already do: use screenwash and not water as wiper fluid. The beauty of preventive health is that simple solutions can often lead to meaningful outcomes. As the cliché goes, “an ounce of prevention is worth a pound of cure.” The harder part is convincing the public to share this philosophy. Hey, it is much easier to succumb to the immediate gratification of a Quadruple Whopper Burger than contemplate its atherosclerotic effects on our coronary arteries.
- Source
- Wallensten A, Oliver I, Ricketts K, Kafatos G, Stuart JM, & Joseph C (2010). Windscreen wiper fluid without added screenwash in motor vehicles: a newly identified risk factor for Legionnaires’ disease. European journal of epidemiology PMID: 20532623
